Characteristics of Microorganisms Isolated from Blood Cultures at a University Hospital Located in an Island Region During 2003∼2007
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배경: 도서지역 대학병원인 경우 고립된 지리적 환경과 병상규모에 비해 중환자가 많은 특수성으로 인해 혈액배양의분리 균종 및 항균제 내성이 다른 양상을 보일 것으로 예상된다. 이에 일개 도서 대학병원의 5년간 혈액배양 결과를 검토해 보고자 하였다. 방법: 2003년부터 2007년까지 제주대학병원에 내원한 환자에서 혈액배양이 의뢰된 경우 호기성 및 혐기성 배양병에 나누어 접종 후 BacT/Alert system에 배양하였고 Vitek II system을 통해 균종 동정과 항균제 감수성검사를 시행하였다. 결과: 혈액배양 양성률은 9.6%, 오염률은 3.6%였고, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae 순으로 분리되었다. 그람양성 간균, 그람음성 구균, 혐기성 세균은 분리되지 않았고, 진균 분리율은 0.6%였다. Methicillin-resistant S. aureus (MRSA)는 2003년 68.0%, 2004년 41.4%, 2005년 48.1%, 2006년 54.5%, 2007년 65.2%였다. Vancomycin-resistant enterococcus (VRE)는 2004년까지는 발생하지 않다가 2005년 16.7%, 2006년 10.0%, 2007년 9.5%였다. 결론: 혈액배양에서 가장 흔히 분리되는 균종들은 타병원 예와 같았지만, MRSA나 VRE의 연도별 분리율은 다른 양상을 보였다. 또한, 그람양성 간균, 그람음성 구균, 혐기성 세균은 분리되지 않았다. 경험적 항균요법의 약제 선택에 도움이 되기 위해서는 앞으로 미흡한 균동정 체계를 재정비하고 항균제 사용량 등 지역의 특수성을 감안한 연구가 필요할 것으로 생각된다.
Abstract
Background: The referral hospital is somewhat isolated from the mainland due to its island status; thus,microorganisms isolated from blood cultures might have a distinct pattern in their frequency and antibiogram. We attempted to uncover these characteristics. Methods: The isolates from blood cultures at the Cheju University Hospital during 2003∼2007 were analysed. After inoculation in aerobic and anaerobic bottles, blood specimens were cultured using BacT/ Alert system, and the isolates were identifieded and antimicrobial susceptibilities were tested using Vitek II system. Results: The overall positive rate of blood cultures was 9.6% and contamination rate was 3.6%. The most commonly isolated pathogens were Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae. Gram positive rod, gram negative cocci, and anaerobes were not isolated, but fungi were isolated in 0.6% of blood cultures. The prevalence of methicillin- resistant S. aureus (MRSA) was 68.0% in 2003, 41.4% in 2004, 48.1% in 2005, 54.5% in 2006, and 65.2% in 2007. The prevalence of vancomycin-resistant enterococcus (VRE) was 0% in 2003 and 2004, 16.7% in 2005, 10.0% in 2006, and 9.5% in 2007. Conclusion: The most commonly isolated pathogens were similar to those from other hospitals, but the isolation rates of MRSA and VRE by year showed different patterns. Also, gram positive rods, gram negative cocci and anaerobes were not isolated. To help the choice of empirical antibiotic treatments, we need complementary measures to upgrade microorganism isolation systems and further studies including the monitoring of antibiotic use.
참고문헌 (17)
- Bryan CS, "Clinical implications of positive cultures", Clin Microbiol Rev, 2, pp.329~353 (1989)
- Lee GI, "Results of blood cultures at Ewha Womans' University Hospital in Recent 5 years", Korean J Lab Med, 8, pp.169~175 (1988)
- Ahn GY, "Trends of the species and antimicrobial susceptibility of microorganisms isolated from blood cultures of patients", Korean J Clin Microbiol, 9, pp.42~50 (2006)
- Koh EM, "Microorganisms isolated from blood cultures and their antimicrobial susceptibility patterns at a university hospital during 1994-2003", Korean J Lab Med, 27, pp.265~275 (2007)
- National Nosocomial Infections Surveillance System, "National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004", Am J Infect Control, 32, pp.470~485 (2004)
- "Performance standards for antimicrobial susceptibility testing; tenth informational supplement M 100-S10. Wayne", PA; National Committee for Clinical Laboratory Standards, ~, pp.National Committee for Clinical Laboratory Standards (2005)
- Kim HO, "Organisms isolated from blood at the Yonsei medical center. 1974-1983", Infect Chemother, 17, pp.15~32 (1985)
- Kim HK, "Blood culture results at the Severance Hospital during 1984-1993", Infect Chemother, 28, pp.151~66 (1996)
- Mylotte JM, "Blood cultures: clinical aspects and controversies", Eur J Clin Microbiol Infect Dis, 19, pp.157~163 (2000)
- Goldstein EJ, "Anaerobic bacteremia", Clin Infect Dis, 23, pp.S97~101 (1996)
- Edmond MB, "Nosocomial bloodstrem infections in United States hospitals: a three-year analysis", Clin Infect Dis, 29, pp.239~244 (1999)
- Krcmery V, "Non-albicans Candida spp. causing fungaemia: pathogenicity and antifungal resistance", J Hosp Infect, 50, pp.243~260 (2002)
- Kim KA, "Causative organisms of neonatal sepsis", Yeungnam Univ J Med, 16, pp.60~68 (1999)
- Orrett FA, "Bacteremia in children at a regional hospital in Trinidad", Int J Infect Dis, 11, pp.145~151 (2007)
- Uh Y, "The species and antimicrobial susceptibility of microorganisms isolated from blood cultures of patients", J Korean Soc Microbiol, 26, pp.417~430 (1991)
- Leclercq R, "Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium", N Engl J Med, 319, pp.157~161 (1988)
- Hong SG, "Prevlence and diversity of extended-spectrum β-lactamase -producing Escherichia coli and Klebsiella pneumoniae isolates in Korea", Korean J Clin Microbiol, 6, pp.149~155 (2003)